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Accelerated versus conventional radial pressure wave therapy for symptomatic calcaneal spur: A randomized clinical
1Department of Sports Medicine, Medical Faculty of Uludag University, Bursa, Turkey.
Introduction:
Calcaneal spurs are bony outgrowths typically originating from the medial calcaneal tuberosity and are commonly associated with chronic plantar heel pain. Radial pressure wave therapy (rPWT) is widely used when symptoms do not respond to conservative treatments; however, optimal treatment intervals and scheduling remain unclear. This study aimed to compare conventional and accelerated rPWT schedules to determine whether a shorter treatment duration could achieve similar clinical outcomes.
Materials And Methods:
Sixty-eight participants with heel pain lasting at least six months and radiographically confirmed calcaneal spurs were randomly assigned to either a Conventional group (n=34), receiving three rPWT sessions at weekly intervals over 14 days, or an Accelerated group (n=34), receiving three sessions every other day over 5 days. Identical treatment parameters were applied in both groups (maximum tolerable pressure, 8Hz frequency, 2000 pulses per session). Pain intensity was assessed using the Visual Analog Scale (VAS) at baseline, post-treatment, and 1-year follow-up. Functional outcomes (Foot Function Index [FFI], Roles-Maudsley [RM] score), calcaneal spur length, and plantar fascia thickness were evaluated at baseline and post-treatment.
Results:
Both groups showed significant improvements in pain and functional outcomes, including VAS, RM, and FFI scores (p<0.001 for within-group comparisons). Calcaneal spur length decreased in both groups, while plantar fascia thickness did not demonstrate significant post-treatment changes. No statistically significant differences were observed between the Conventional and Accelerated groups for any clinical or structural outcome. At the 1-year follow-up, VAS scores remained comparable between groups, with no significant group×time interaction [F(2,36)=0.014, p=0.775].
Conclusion:
Conventional and accelerated rPWT schedules resulted in similar short-term clinical improvements in patients with symptomatic calcaneal spurs. Under the conditions of this study, an accelerated protocol may allow completion of treatment within a shorter time frame without clear evidence of inferior clinical outcomes. These findings should be interpreted cautiously in light of methodological limitations, and further studies are needed to confirm long-term effects and optimal treatment scheduling.
